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Use of Grading Scales in Venous Air Emboli During Neurosurgery
Correspondence
Use of Grading Scales in Venous Air Emboli During Neurosurgery
REFERENCES
LETTER:
1. Domaingue CM: Anaesthesia for neurosurgery in the sitting position: a practical approach. Anaesth Intensive Care 33:323-331, 2005.
great interest the excellent article by Feigl et al. W e(2).readThewithauthors introduce the Tübingen venous air embolism grading scale, which can be used for grading the clinical severity of venous air embolism during neurosurgery, and state that it categorizes the risk of a cardiovascular event depending on the described parameter changes and visible air bubbles on transesophageal echocardiography. If this were true, the scale may be useful, but the authors failed to validate it for that purpose, meaning it can be used only for descriptive purposes. In itself that is not a problem, but several comparable scales are in use already (1, 3-6). All scales differ in the details, causing problems comparing the data in systematic reviews. New scales should be introduced sparingly and preferably after validation for either an outcome or a management decision. Dennis R. Buis and Yen-Mie Lai Neurosurgical Center Amsterdam, Amsterdam, The Netherlands To whom correspondence should be addressed: Dennis R. Buis, M.D., Ph.D. [E-mail: [email protected]] Published online 13 August 2013; http://dx.doi.org/10.1016/j.wneu.2013.08.009.
WORLD NEUROSURGERY 00 [0]: e1, MONTH 2013
2. Feigl GC, Decker K, Wurms M, et al: Neurosurgical procedures in the semisitting position: evaluation of the risk of paradoxical venous air embolism in patients with a patent foramen ovale. World Neurosurg 2013 Jan 7, 2013 Jan 7 [Epub ahead of print].
3. Girard F, Ruel M, McKenty S, et al: Incidences of venous air embolism and patent foramen ovale among patients undergoing selective peripheral denervation in the sitting position. Neurosurgery 53:316-319, 2003.
4. Jadik S, Wissing H, Friedrich K, et al: A standardized protocol for the prevention of clinically relevant venous air embolism during neurosurgical interventions in the semisitting position. Neurosurgery 64:533-538, 2009.
5. Lobato EB, Black S, De SH: Venous air embolism and selective denervation for torticollis. Anesth Analg 84:551-553, 1997.
6. von Gosseln HH, Samii M, Suhr D, et al: The lounging position for posterior fossa surgery: anesthesiological considerations regarding air embolism. Childs Nerv Syst 7:368-374, 1991.
www.WORLDNEUROSURGERY.org
e1
Use of Grading Scales in Venous Air Emboli During Neurosurgery
REFERENCES
LETTER:
1. Domaingue CM: Anaesthesia for neurosurgery in the sitting position: a practical approach. Anaesth Intensive Care 33:323-331, 2005.
great interest the excellent article by Feigl et al. W e(2).readThewithauthors introduce the Tübingen venous air embolism grading scale, which can be used for grading the clinical severity of venous air embolism during neurosurgery, and state that it categorizes the risk of a cardiovascular event depending on the described parameter changes and visible air bubbles on transesophageal echocardiography. If this were true, the scale may be useful, but the authors failed to validate it for that purpose, meaning it can be used only for descriptive purposes. In itself that is not a problem, but several comparable scales are in use already (1, 3-6). All scales differ in the details, causing problems comparing the data in systematic reviews. New scales should be introduced sparingly and preferably after validation for either an outcome or a management decision. Dennis R. Buis and Yen-Mie Lai Neurosurgical Center Amsterdam, Amsterdam, The Netherlands To whom correspondence should be addressed: Dennis R. Buis, M.D., Ph.D. [E-mail: [email protected]] Published online 13 August 2013; http://dx.doi.org/10.1016/j.wneu.2013.08.009.
WORLD NEUROSURGERY 00 [0]: e1, MONTH 2013
2. Feigl GC, Decker K, Wurms M, et al: Neurosurgical procedures in the semisitting position: evaluation of the risk of paradoxical venous air embolism in patients with a patent foramen ovale. World Neurosurg 2013 Jan 7, 2013 Jan 7 [Epub ahead of print].
3. Girard F, Ruel M, McKenty S, et al: Incidences of venous air embolism and patent foramen ovale among patients undergoing selective peripheral denervation in the sitting position. Neurosurgery 53:316-319, 2003.
4. Jadik S, Wissing H, Friedrich K, et al: A standardized protocol for the prevention of clinically relevant venous air embolism during neurosurgical interventions in the semisitting position. Neurosurgery 64:533-538, 2009.
5. Lobato EB, Black S, De SH: Venous air embolism and selective denervation for torticollis. Anesth Analg 84:551-553, 1997.
6. von Gosseln HH, Samii M, Suhr D, et al: The lounging position for posterior fossa surgery: anesthesiological considerations regarding air embolism. Childs Nerv Syst 7:368-374, 1991.
www.WORLDNEUROSURGERY.org
e1